Stephen Peter Nicholas, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME140408 Issued in FL

Practice address

1505 53Rd Ave E
Bradenton, FL 34203-4249

Phone

(941) 357-7950

Fax

(941) 840-1003

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD
• Edward W Heidbrier MD PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1720348600
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1780643742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034249",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034249",
            "telephone_number": "941-357-7950",
            "fax_number": "941-840-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "STEPHEN",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME140408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202193207",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tri D Nguyen, M.D.
• Vincent Nguyen
• Yen Nguyen
• Nic 4 Bradenton Oaks Leasing LLC (Bradenton Oaks Courtyard)
• Nic 4 Summerfield Leasing LLC (Summerfield Retirement)
• Earl J Nichols, LMFT
• John Dale Nichols, D.C.
• Katherine E Nicholson, BSW
• Rebecca Anne Nickens-Warren, APRN
• Linda K Nicoli, PT

• Internal Medicine Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.